Chronic pain is a major health problem, commonly accompanied and aggravated by emotional difficulties. If we look for, recognise and treat co-occurring psychiatric issues, we may improve outcomes for many patients.
Nearly one in five Australians suffers from chronic or persisting pain, and the prevalence is expected to increase as our population ages. Whatever the original cause of an individual’s pain, it is often a sensitised nervous system rather than structural tissue damage that is most strongly correlated with persistence of the pain. The concepts of neuroplasticity and central sensitisation are increasingly used to explain how such persistence develops. Persistent pain is commonly linked to emotional distress and serious mental health problems. Such comorbid psychiatric conditions, which are often unrecognised, may interfere with a patient’s response to treatment and make successful pain management more difficult. If these psychiatric conditions are recognised and treated and function improves, it should make for a happier patient (and a happier doctor).